Liver Disease Expert: New Hepatitis C Drugs ‘Game Changing’

In October, the U.S. Food and Drug Administration approved the first HCV treatments that cure patients without interferon. Additional therapies are expected to be approved by the end of 2014 and others are in development.

“This new wave of therapies is game changing,” says Talal, professor of medicine in the Division of Gastroenterology, Hepatology and Nutrition.

Over the next several years, the ability to use these far superior therapies means HCV treatment will undergo a major paradigm shift, Talal adds.

He lists several notable advantages of the new drugs over standard treatment, including:

• typical cure rate of 95 percent or higher
• likely to make liver transplants for HCV much less common
• first to effectively target all of the virus’s genotypes
• oral vs. injectable
• fewer side effects
• can be used for a substantially shorter duration

Left untreated, HCV and other liver diseases can cause liver failure for which a liver transplant has been the only management strategy.

Chronic liver disease affects at least 3.2 million people in the United States and as many as 170 million worldwide.

More Americans are expected to be diagnosed with the HCV infection as new U.S. Centers for Disease Control and Prevention guidelines call for screening all people born between 1945 and 1965. A New York State law now requires health care providers to offer HCV screening to patients in this age group.

Talal is among a small group of scientists studying exactly what happens to HCV drugs in the body.

Through interdisciplinary collaborations, he is working toward two interrelated goals: to enhance understanding of how the new therapies work and to expand access to treatment for those who have traditionally been excluded from therapy.

“We’re assessing drug concentrations in the liver to better define dosing guidelines, drug-drug interactions and toxicities. We are also developing new approaches to patient care,” says Talal.

“As leaders in the field, our findings are going to be critical to how patients with HCV and other liver diseases will be treated,” he notes.

In addition to seeing clinic patients at Buffalo General Medical Center and Erie County Medical Center, Talal and others are investigating the use of telemedicine to treat patients in a methadone maintenance program.

“For our research, we obtain samples from patients evaluated both in our clinics and through telemedicine, and we use our results to improve care.”

Integrating clinical care with research benefits patients as well as researchers.

“Laboratory scientists do not typically have ready access to clinical samples,” he notes.

This alignment also provides a rich, comprehensive experience for trainees preparing for academic careers in liver disease.

“This is exactly the type of environment research trainees are seeking,” he notes.